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There is some uncertainty surrounding the role of age in the outcome of cervical cancer. Some studies indicate that young women have a worse prognosis than older women with this cancer, while other studies have not found a relation between age and prognosis. Among the studies that have indicated a poorer prognosis for younger women, there is some difference in the age range over which this apparent effect seems to take place. Furthermore, the women in these studies are likely to have different stages of disease and to have received different methods of treatment. To clarify the role of age in the prognosis of cervical cancer, a study was conducted to determine which tumor characteristics might be different among younger women. A total of 380 patients who underwent radical hysterectomy for cervical cancer were studied. All the women had the specific form of cancer called squamous cell carcinoma, and all had disease that was either Stage IB or more advanced. These patients were divided into age groups covering the decades from 30 to 39, 40 to 49, 50 to 59, and 60 to 69 years. The microscopic features of the cancer were examined, including the cell types, the depth of cancer invasion of the underlying tissues, the invasion of the blood vessels by the cancer, and the spread of cancer to the local lymph nodes. All of these factors are known to affect the prognosis of the disease. However, of these factors, only the spread of cancer to the lymph nodes appeared to be influenced by age. The women in the 60 to 69 age group were significantly less likely to have metastatic cancer spread to the lymph nodes than were the women in the younger age groups. Although lymph node metastasis is an indicator of poor prognosis, it was also found that among the 60- to 69-year-old women with lymph node metastases, survival was superior to comparable patients in the younger groups. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abstract: Background. As the prognosis of ovarian cancer has improved with recent therapy, some prognostic factors have lost their clinical significance. The purpose of this study was to evaluate prognostic factors in stage I ovarian cancer in patients with improved prognosis because of cisplatin combination chemotherapy. Methods. Multivariate analysis was performed with 14 clinicopathologic prognostic factors obtained from 170 patients with stage I ovarian cancer (borderline tumors were excluded), who had been surgically treated between 1983 and 1995. Results. The 5-year survival rate was 94.5% for all stage I patients, 98.0% in stage IA, 100% in stage IB, and 92.6% in stage IC. Significant prognostic factors determined by the Kaplan-Meier method were spontaneous rupture of the capsule and capsular invasion (P < 0.05, and P < 0.01). Multivariate analysis, however, showed that spontaneous rupture of the capsule was the only significant prognostic factor (P = 0.02627). Both analyses showed that histologic type, histologic grading, intrapelvic cytology, operative procedure, and chemotherapy had little influence on prognosis. Conclusion. Multivariate analysis showed that spontaneous rupture of the capsule was the only significant prognostic factor in patients with stage I ovarian cancer who received cisplatin chemotherapy.

In normal and molar pregnancy, a morphological discrimination between nonvillous trophoblasts which lie scattered in the placental bed and surrounding maternal cells is considered to be difficult. We examined the reactivity of two monoclonal antibodies (Troma 1 and CAM 5.2) against cytoker-atin by an immunoperoxidase technique and analyzed their usefulness as a histological trophoblast marker. Materials were taken from 42 uteri with normal pregnancy, 7 uteri with hydatidiform mole, 2 uteri with gestational choriocarcinoma, 1 fallopian tube with nongestational choriocarcinoma, 5 delivered term placentae of normal pregnancy, and 5 nongestational uteri. The reactivities of Troma 1 on frozen sections and those of CAM 5.2 on paraffin sections were identical. They reacted with surface epithelium and gland epithelium in the nongestational uterine corpus. In the implantation site of normal and molar pregnancy, they reacted with villous and nonvillous trophoblasts as well as endometrial gland epithelium. In gestational and nongestational choriocarcinoma, they reacted with carcinoma cells specifically. Since the histological detection of gland epithelium may not be difficult, it was concluded that the two antibodies were very beneficial as a histological marker for trophoblasts in normal pregnancy and trophoblastic disease.

A subline predisposed to pulmonary metastasis was successfully derived by repeating in vivo selection of GCH-1, a human gestational choriocarcinoma cell line, in nude mice. While the parent line GCH-1, transplanted subcutaneously to nude mice, induced pulmonary metastasis in a few of the host animals, the newly established subline GCH-l(m) successfully metastasized to the lungs in 100% of them. Compared with GCH-1, GCH-l(m) exhibited a higher degree of cell atypia, a lower capacity for cell growth and markedly higher productivity for human chorionic gonadotropin (hCG). Another characteristic of this subline was its enhanced growth after the addition of a pulmonary extract obtained from nude mice. The relationship of these findings to the mechanisms of metastasis of this cancer was discussed.

Clinical and pathologic analyses were performed in 30 patients with Paget's disease of the vulva to investigate the risk factors for recurrence. From 1971 to 1993, we carried out histologic examinations in 27 resected vulvae to detect Paget's cells at the surgical margin. Prior to 1981, 9 patients underwent the examination, and 6 of them had positive surgical margins, and 2 of these 6 patients had local recurrence. After 1982, the preoperative multiple biopsy and intraoperative frozen section diagnosis of the surgical margins were performed, and as a result, cases of the lesions remaining as stumps on the vaginal side decreased in 7 of 18 examined patients. In these 7 cases, 2 cases had local recurrence. The patients were further divided into three groups according to histologic findings to investigate their prognosis: 10 patients with intraepithelial Paget's discase (IEP), 9 patients with minimally invasive Paget's disease (MIP), and 11 patients with underlying carcinoma (UC) including 2 cases of carcinoma in situ. Four locally recurrent cases were found in IEP or MIP, and the longest period from surgery to recurrence was 8 years and 4 months. The invasive UC lesions persisted or recurred shortly after surgery (median, 10 months) in 5 of the 6 patients with general metastasis. For IEP and MIP, surgical margins of the vaginal side should be carefully examined with preoperative multiple biopsy and intraoperative frozen section, and also a long-term follow-up is necessary. With regard to invasive UC patients, their prognosis was found to be very poor for general metastasis.

Systemic amyloidosis of the amyloid A (AA) type, is occasionally associated with various neoplasms, but the cause is still unclear. We obtained interleukin 6 (IL-6)-producing cells designated YO from a primary culture of a malignant peritoneal mesothelioma of epithelial type obtained from a 62-year-old woman. Post mortem examination revealed that the patient had systemic amyloidosis of the AA type. The supernatant media of YO cells, as well as recombinant human IL-6, successfully induced nonneoplastic liver cells to produce serum AA (SAA). Our data suggest that IL-6 produced by the tumor cells may have played an important role in the paraneoplastic syndrome of AA amyloidosis in this patient.